目的 依据心血管病风险分层对高血压飞行人员进行医学鉴定,进一步探讨高血压飞行人员医学鉴定新方法. 方法 空军总医院全军临床航空医学中心2002年1月至2012年12月收治的原发性高血压飞行人员140例,根据飞行机种分为3组,A组为歼击机、强击机、教练机飞行员组(54例),B组为轰炸机、直升机飞行人员组(20例),C组为运输机、预警机飞行人员组(66例).依据心血管病风险分层的航空医学鉴定方法,对飞行人员合格率和不合格率进行统计分析,并与基于高血压分期的航空医学鉴定方法进行比较,评价其航空医学鉴定效果. 结果 A组、B组和C组的飞行合格率分别为22.22％、40.00％和71.21％,飞行不合格率分别为59.26％、40.00％、19.70％,组间比较差异均具有统计学意义(x2 =27.04、19.81,P＜0.01).C组飞行人员合格率高于A、B两组(x2=26.51、5.59,P＜0.01或0.05),A组飞行员不合格率高于C组(x2=19.83,P＜0.01).两种医学鉴定方法的总飞行合格率与不合格率差异均具有统计学意义(x2=9.39、12.03,P＜0.01).经随访,放飞飞行人员飞行适应性良好. 结论 高血压飞行人员医学鉴定结论与飞行机种密切相关,提示其飞行结论不仅要考虑心血管病危险因素控制水平与治疗效果,还应根据飞行机种分别评定.依据心血管病风险分层的航空医学鉴定方法,显著降低了高血压飞行人员的不合格率,提高了放飞率,进一步提高了飞行人员高血压医学鉴定水平.“,”Objective To investigate the new evaluation method for the flying personnel with hypertension by conducting the cardiovascular risk stratification in aeromedical assessment.Methods One hundred and forty essential hypertension flying personnel who were admitted by Center of Clinical Aviation Medicine in Air Force General Hospital from January 2002 to December 2012 were selected as subjects.They were divided into three groups:group A (fighter,attacker and trainer flying personnel,n =54),group B (bomber and helicopter flying personnel,n =20) and group C (transporter and airborne warning and control system flying personnel,n=66).The rates of flying qualification and disqualification were analyzed according to the aeromedical assessment based on stratification of cardiovascular risk,and were compared with those in the assessment by hypertension stage.The effects of new assessments were evaluated.Results The qualification rate of flying personnel in group A,group B and group C was 22.22％,40.00％ and 71.21％ respectively while the disqualification rate was 59.26％,40.00％ and 19.70％ respectively.There were significant differences on flying qualification and disqualification rates of flying personnel among 3 groups (x2 =27.04,19.81,P＜0.01).Qualification rate of the flying personnel in group C was significant higher than that in group A and B (x2 =26.51,5.59,P＜0.01 or 0.05).Disqualification rate of flying personnel in group A was significant higher than that in group C (x2 =19.83,P＜0.01).The total qualification and disqualification rates depended by 2 methods were significantly different (x2=9.39,12.03,P＜ 0.01).The qualified flying personnel were well adapted to flying according to the follow-up.Conclusions The medical assessment of flying personnel with hypertension has close relationship with aircraft types.It is suggested that the medical assessment is not only based on the controlling and treatment of cardiovascular risk factors but also consider aircraft types.The new aeromedical assessment for the flying personnel with hypertension based on cardiovascular risk stratification contributes significantly lower disqualification rate and enables more qualifications.It indicates the improvement on the aeromedical assessment for the flying personnel with hypertension.